Health News
Legislation to Cap Out-of-Pocket Drug Costs
August 19th, 2009
Bill provides access to drugs that help prevent disability for people with arthritis.
A new bill supported by the Arthritis Foundation and introduced by Sen. John. D. Rockefeller IV (D-W.Va.) aims to make expensive medications more affordable to many Americans. The Affordable Access to Prescription Medications Act of 2009 would cap monthly out-of-pocket spending on prescription drugs, including medications that are critical to the health and quality of life for people with arthritis.
As more insurers move vital medications onto what is referred to as a specialty tier for medications over $600 a month, prescription drugs necessary to maintain health and prevent disability are becoming out of reach. For insured people with chronic diseases such as rheumatoid arthritis, a co-payment of 20 to 35 percent could amount to hundreds of dollars a month per prescription. Without cheaper alternatives to disease-modifying therapies, individuals unable to afford co-payments may go without crucial medications that could slow the progression of the disease and prevent future disability.
The Affordable Access to Prescription Medications Act would help control monthly out-of-pocket costs for medications by creating a monthly cap of $200 per person for any one prescription, and a $500 per person cap for all prescriptions in any given month. These caps apply to all public and private insurance coverage, including Medicare prescription drug plans, and will reduce costs for the most vulnerable populations by more than 50 percent.
"The Arthritis Foundation applauds Sen. Rockefeller for his leadership in protecting Americans, particularly those affected by a disability or a chronic disease like arthritis, from the risk of incurring extraordinarily high out-of-pocket expenses," said Amy Melnick, chief public policy officer for the Arthritis Foundation. "We strongly believe that legislative action is necessary to guarantee quality, affordable, essential health care for all Americans, and recommend this issue be incorporated into current health care reform proposals."
Arthritis is a painful and life-altering disease that affects one in five people, and it is the nation's most common cause of disability. Studies show that out-of-pocket costs are rising faster for arthritis than for many other chronic conditions. In fact, a 2007 study showed that 28 percent of working-age adults with chronic conditions such as arthritis reported that their families had trouble paying medical bills. Of those, 56 percent failed to get prescription medications because of cost concerns. These unmet needs are putting people with arthritis at greater risk for complications and permanent disability.
The Arthritis Foundation supports health care reform that will improve the lives of people with arthritis and other chronic diseases.
SOURCE: The Arthritis Foundation
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